Problem Solving in Dance/Movement Therapy Research: Developing an Intervention Protocol for Adults Living with Treatment Resistant Depression

Long-Term Vagus Nerve Stimulation for Severe Refractory Depression: A Case Study With a Six-Year Follow-Up

In this article, a comparative analysis of creative and innovative thinking in a similar and different way will be made. The peculiarities of creativity and the essence of innovation are considered to be brought up as an object of philosophical research. Within the framework of the theme, it is mentioned about how our young people can use the opportunities created in our country on a large scale, about the achievement of the goals, the pursuit of innovation, creative thinking consisting of creative processes in a specific way and the various methods used in the mobilization of its implementation and their practical opportunities. Also, analytical analysis of the characteristic aspects of innovative thinking was carried out.The essence and essence of creative and innovational thinking, its distinctive features are considered to be brought up as an object of philosophical research. The views on innovation and creative thinking were also analyzed comparatively. In particular, it is noted that the formation of creative and innovative thinking is a period demand as well as a social need.

Innovative creative thinking skills play an important role in supporting students in solving mathematical concepts, especially simple multiplication operational problem with Jarimatika. The researchers applied mixed methods with a sequential explanatory design. Research subjects were 28 students in the experimental class and 26 students in the control class. Data were collected through validation sheet, test, documentation, and prerequisite test. The research result indicated that after the implementation of Discovery Learning-based learning instruments, the percentage of students’ innovative creative thinking for the control class was 11.54% for the very creative innovative level, 69.23% for the innovative creative level, 19.23% for the enough innovative creative level, and 0% for less or not innovative creative level. While the experimental class far exceeds the control class, 39% for the very creative innovative level, 57% for the innovative creative level, 4% for the enough creative innovative level, and 0% for less or not innovative creative level. The independent sample t-test score from the post-test shows that there is a significant difference between the control class and the experimental class with a t-count value of -4,965 with a significance value of 0,000. The significance value is smaller than the α value (0.05). This shows that there is an average difference between the control class and the experimental class after receiving treatment (post-test). The negative sign on the t-value indicates that the average experimental class is higher than the control class. It can be concluded that the application of Discovery Learning-based learning instruments can improve elementary school students’ innovative creative thinking skills in solving simple multiplication operation problem with Jaritmatika.

This paper documents one of several themes arising from a larger research study which invited trainees’ views on their experience in a weekly, 2 year, dance movement therapy (DMT) personal development group. This group formed part of their post-graduate training. The study used a phenomenological, grounded theory and collaborative methodology followed by an interpretive framework. The research sought to discover participants’ views on the experience of this personal development group in relation to their clinical practice with DMT groups during and following their training (the latter is not the subject of this paper). The study identifies a gap in the literature on trainee experience, particularly in relation to group process. Following a brief introduction and overview of methodology employed, the theme entitled ‘becoming a client, becoming a practitioner’ is presented, as it manifested for the students in the DMT group over time. The personal development component of therapists’ training is directly relevant to most counselling/psychotherapy and arts therapies practitioners; consequently, the study has broader implications.

This qualitative research explores creative movement processes such as dance/movement therapy (DMT), authentic movement (AM), and creative dance (CD) as possible tools for transforming sexual trauma for women. Eleven movement professionals were interviewed in a semi-structured research format. My direct experience and knowledge of sexual abuse, sexual trauma, and creative movement processes are interwoven with the research question: do creative dance/movement therapy processes contribute to the dynamic of healing for women transforming sexual trauma? These findings are inconclusive for the greater population of survivors of sexual abuse and sexual trauma. However, there are indications that DMT, AM, and CD may be potential tools for recovery. This research contributes to a dialogue about sexual abuse and recovery from sexual trauma.

Importance of the field: Treatment-resistant depression (TRD) is common and debilitating. Initial treatment is often insufficient to achieve full remission in a given depressive episode, resulting in more frequent episodes, worsened severity, and major disability.Areas covered in this review: This review surveys literature on the diagnosis and pharmacological management of TRD in light of recent developments. Evidence regarding commonly used treatment options is critically examined and key recommendations are offered. The review ends by considering drugs acting on the melatonin, acetylcholine, and glutamate systems that hold promise as future options for TRD.What the reader will gain: Recent trends and research findings have impacted how the evidence supporting different approaches to TRD should be evaluated. For example, many earlier TRD studies employed tricyclics as the primary antidepressant, but tricyclics have now been superseded by selective serotonin reuptake inhibitors (SSRIs) in routine clinical practice. This deficiency has been addressed by the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, the largest effectiveness study of TRD ever conducted. However, design characteristics of the STAR*D study preclude simple comparisons with earlier studies.Take home message: A shortcoming of most treatment recommendations for TRD is their reliance on older studies that do not reflect the current preeminence of SSRIs in clinical practice. This has distorted the prioritization of pharmacological strategies for TRD. Efforts to correct this distortion with effectiveness research, designed to better reflect current practice trends, require critical consideration of the strengths and limitations of this approach.

BackgroundDespite the availability of effective therapies, many patients with major depressive disorder (MDD) develop treatment-resistant depression (TRD).AimsTo evaluate and compare prescribing patterns, contact with specialist services and treatment outcomes in patients with MDD and TRD.MethodThis was a retrospective analysis of linked primary and secondary care National Health Service data in the north-west London Discover-NOW data-set. Eligible patients were adults who had diagnostic codes for depression and had been prescribed at least one antidepressant between 2015 and 2020.ResultsA total of 110 406 patients were included, comprising 101 333 (92%) with MDD and 9073 (8%) with TRD. Patients with TRD had significantly higher risks of suicidal behaviour and comorbidities such as anxiety, asthma, and alcohol or substance misuse (all P < 0.0001). Citalopram, sertraline, fluoxetine and mirtazapine accounted for 83% of MDD and 71% of TRD prescriptions. Use of antidepressant switching (1% MDD, 7% TRD) and combination therapy (1%, 5%) was rare, whereas augmentation occurred more frequently in the TRD group (4%, 35%). Remission was recorded in 42 348 (42%) patients with MDD and 1188 (13%) with TRD (P < 0.0001), whereas relapse was seen in 20 970 (21%) and 4923 (54%), respectively (P < 0.0001). Mean times from diagnosis to first contact with mental health services were 38.9 (s.d. 33.6) months for MDD and 41.5 (s.d. 32.0) months for TRD (P < 0.0001).ConclusionsThere appears to be a considerable difference between treatment guidelines for depression and TRD and the reality of clinical practice. Long-term treatment with single antidepressants, poor remission, and high relapse rates among patients in primary care highlight the need to optimise treatment pathways and access to newer therapies.

Dual antidepressant combination for treatment-resistant depression is a strategy well supported by literature and accepted in clinical practice. Rather, the usefulness of the combination of more than two antidepressants is controversial. This may be related to the possibility of higher side-effect burden and to doubts about its pharmacological effectiveness and therapeutic advantage compared to other standard treatment options. We report a relapse of moderate-to-severe depressive symptoms with insomnia that successfully remitted after the addition of trazodone to a dual combination of paroxetine and mirtazapine (in standard effective doses) in a patient with treatment-resistant depression. We also review the literature and discuss the utility of triple antidepressant combination in treatment-resistant depression. This clinical case highlights the utility of combining trazodone as a third antidepressant for the relapse of depressive symptoms after the failure of a dual antidepressant combination. Trazodone may be advantageous in patients presenting recurrence of moderate-to-severe depressive symptoms that include sleep problems and/or insomnia and may be particularly useful when benzodiazepines are not recommended. Although its use may be controversial and associated with higher risk of side-effects, more investigation is needed to determine the efficacy and safety for triple antidepressant combinations as reliable strategies for treatment-resistant depression in clinical practice.

In recent years, industrial designers are required to design creative products in a short period of time. Attractive product is changed significantly by requirement definition and conceptual design phases. The Quality of product concepts, which is result of these phases, depend heavily on the creativity of designers or development teams. It is difficult that a computer-aided system supports a creative and inventive thinking process, and searches a creative design solution. To overcome these difficulties, authors developed a systematic approach of the creative and inventive thinking process called Creative and inventive Design Support System (CDSS). In this paper, its validity is examined by using to the Design of Experiments (DOE) and the Taguchi Method. From these evaluation results, it is confirmed that creative design solutions can be searched by using the creative and inventive thinking process of CDSS.

Creative thinking is the core of creative ability, and the level of individual creative thinking ability is an important reflection of its creative ability. The article reviews the literature on innovative thinking at home and abroad, systematically sorts out and summarizes the concepts and characteristics of innovative thinking, summarizes the status and problems of innovative thinking research at home and abroad, and then puts forward the deficiencies of research including academic circles about innovation. The definition of the concept of thinking is not unified; there are different understandings of the characteristics of innovative thinking in the academic world; the number of innovative thinking studies is relatively small and the research direction is not clear; the macro-level research of innovative thinking training is insufficient and the countermeasures are not targeted. It also proposes future research directions for innovative thinking from strengthening theoretical research, strengthening macro- and micro-level research on innovative thinking cultivation, and strengthening scientific research activities as an important way to cultivate college students’ innovative thinking, to enrich the theory and talent cultivation of innovative thinking. Important decision-making reference.

Treatment-resistant depression (TRD) is common and associated with multiple serious public health implications. A consensus definition of TRD with demonstrated predictive utility in terms of clinical decision-making and health outcomes does not currently exist. Instead, a plethora of definitions have been proposed, which vary significantly in their conceptual framework. The absence of a consensus definition hampers precise estimates of the prevalence of TRD, and also belies efforts to identify risk factors, prevention opportunities, and effective interventions. In addition, it results in heterogeneity in clinical practice decision-making, adversely affecting quality of care. The US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have adopted the most used definition of TRD (i.e., inadequate response to a minimum of two antidepressants despite adequacy of the treatment trial and adherence to treatment). It is currently estimated that at least 30% of persons with depression meet this definition. A significant percentage of persons with TRD are actually pseudo-resistant (e.g., due to inadequacy of treatment trials or non-adherence to treatment). Although multiple sociodemographic, clinical, treatment and contextual factors are known to negatively moderate response in persons with depression, very few factors are regarded as predictive of non-response across multiple modalities of treatment. Intravenous ketamine and intranasal esketamine (co-administered with an antidepressant) are established as efficacious in the management of TRD. Some second-generation antipsychotics (e.g., aripiprazole, brexpiprazole, cariprazine, quetiapine XR) are proven effective as adjunctive treatments to antidepressants in partial responders, but only the olanzapine-fluoxetine combination has been studied in FDA-defined TRD. Repetitive transcranial magnetic stimulation (TMS) is established as effective and FDA-approved for individuals with TRD, with accelerated theta-burst TMS also recently showing efficacy. Electroconvulsive therapy is regarded as an effective acute and maintenance intervention in TRD, with preliminary evidence suggesting non-inferiority to acute intravenous ketamine. Evidence for extending antidepressant trial, medication switching and combining antidepressants is mixed. Manual-based psychotherapies are not established as efficacious on their own in TRD, but offer significant symptomatic relief when added to conventional antidepressants. Digital therapeutics are under study and represent a potential future clinical vista in this population.

French Society for Biological Psychiatry and Neuropsychopharmacology (AFPBN) guidelines for the management of patients with partially responsive depression and treatment-resistant depression: Update 2024

Depression is a common mental disorder that occurs all over the world with treatment resistance commonly seen in clinical practice. Ketamine exhibits an antidepressant that is more often used in the case of treatment-resistant depression (TRD) in MDD and BP. Research emphasizes that a healthy diet and the nutrients it contains can lower the risk of developing depression and form a strategy that supports conventional treatment. The aim of the study was to evaluate the patients’ diet and to analyze the effect of ketamine on food intake among patients with TRD. The study involved 15 patients suffering from treatment-resistant depression and 15 healthy volunteers. The data required for the analysis were collected using the food frequency questionnaire (FFQ) and 4-day food diaries. The study group was statistically significantly less likely to consume milk and plain milk beverages, plain white cheese, wholemeal bread, various vegetables, wine, and drinks. Our results show several disorders in the eating habits of patients with treatment–resistant depression. After the administration of ketamine, the patients consumed significantly less protein, fats, monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA), fiber, tryptophan, vitamins, and minerals compared to the control group. There is a lack of research describing the effects of ketamine on nutrition. In order to confirm the results of the study, more participants are required, and the assessment of food diaries filled in at the patient’s home with a longer interval after the last dose of ketamine as well.

Common neural activations of creativity and exploration: A meta-analysis of task-based fMRI studies.

Depression is a serious and widespread mental health disorder. A significant proportion of patients with depression fail to remit after two antidepressant treatment trials, a condition named treatment-resistant depression (TRD). Clinical practice guidelines (CPGs) are instruments aimed to improve diagnosis and treatment. This study objective is to systematically appraise the quality and elaborate a comparison of high-quality CPGs with high-quality recommendations aimed at TRD. We searched several specialized databases and organizations that develop CPGs. Independent researchers assessed the quality of the CPGs and their recommendations using AGREE II and AGREE-REX instruments, respectively. We selected only high-quality CPGs that included definition and recommendations for TRD. We investigated their divergencies and convergencies as well as weak and strong points. Among seven high-quality CPGs with high-quality recommendations only two (Germany's Nationale Versorgungs Leitlinie-NVL and US Department of Veterans Affairs and Department of Defense-VA/DoD) included specific TRD definition and were selected. We found no convergent therapeutic strategy among these two CPGs. Electroconvulsive therapy is recommended by the NVL but not by the VA/DoD, while repetitive transcranial magnetic stimulation is recommended by the VA/DoD but not by the NVL. While the NVL recommends the use of lithium, and a non-routine use of thyroid or other hormones, psychostimulants, and dopaminergic agents the VA/DoD does not even include these drugs among augmentation strategies. Instead, the VA/DoD recommends ketamine or esketamine as augmentation strategies, while the NVL does not mention these drugs. Other differences between these CPGs include antidepressant combination, psychotherapy as a therapeutic augmentation, and evaluation of the need for hospitalization all of which are only recommended by the NVL. High-quality CPGs for the treatment of depression diverge regarding the definition and use of the term TRD. There is also no convergent approach to TRD from currently high-quality CPGs.